Sleep architecture in Sheehan's syndrome before and 6 months after growth hormone replacement therapy.
OBJECTIVE
To characterize the sleep parameters in patients with growth hormone (GH) deficiency in Sheehan's syndrome adults and to assess the effects of 6-month GH replacement therapy (GHRT).


METHODS
Twenty-two women with Sheehan's syndrome, (mean age; 49.1+/-2.2 years), and 12 women with similar age (mean age; 51.3+/-3.8 years) and body mass index as control subjects were included in the study. Under baseline conditions, women received adequate hormone replacement therapy for all hormonal deficiencies other than GH. Twelve patients received recombinant GH (Genotropin; Pfizer Stockholm, Sweden) (treatment group) and eight patients received placebo (placebo group) for 6 months. Two patients had only baseline evaluation and were not followed up prospectively. Two polysomnography (PSG) recordings were performed on the patients group, one in the baseline period and the other at the sixth month of treatment (either GH or placebo). Control group had only baseline PSG.


RESULTS
GH deficient females with Sheehan's syndrome have more NREM (95.9+/-1.5% and 88.6+/-0.9%, respectively; p<0.05), particularly in stage 4 sleep (11.4+/-1.9% and 4.9+/-1.6, respectively; p<0.05), less REM sleep (4.2+/-1.5% and 11.4+/-0.9, respectively; p<0.05) and also less sleep efficiency (69.7+/-3.4% and 81.1+/-2.8%, respectively; p<0.05) when compared to healthy controls. After 6 months of GHRT there was no significant difference in sleep parameters.


CONCLUSIONS
GH deficiency has sleep disturbing effects on Sheehan's syndrome patients under baseline conditions.
Ismailogullari
Sevda
S
Erciyes University Medical Faculty, Neurology Department, 38039 Kayseri, Turkey. Electronic address: sevdademirci@yahoo.com.
Tanriverdi
Fatih
F
Erciyes University Medical Faculty, Endocrinology Department, 38039 Kayseri, Turkey. Electronic address: fatihtan@yahoo.com.
Kelestimur
Fahrettin
F
Erciyes University Medical Faculty, Endocrinology Department, 38039 Kayseri, Turkey. Electronic address: fktimur@erciyes.edu.tr.
Aksu
Murat
M
Erciyes University Medical Faculty, Neurology Department, 38039 Kayseri, Turkey. Electronic address: aksu@erciyes.edu.tr.
D000328:Adult; D000368:Aged; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D010919:Placebos; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects*
D010919:Placebos; D011994:Recombinant Proteins; D019382:Human Growth Hormone